Showing 18 results for Peyman
Torkaman M, Afsharpeyman Sh, Khalili Matinzadeh Z, Amirsalary S, Kavehmanesh Z, Hashemi S.a,
Volume 64, Issue 10 (2 2006)
Abstract
Background: Jaundice is a common and benign problem in neonatal period. Several therapeutic procedures for decreasing of serum bilirubin level has been recommended. phototherapy is most common them. Our goal Form this study is the evaluation of serum therapy effects in decreasing of serum bilirubin concentration in icteric infants that are treated with phototherapy.
Methods: This is a prospective clinical trial in Najmeih Hospital in 2002. In this study 80 term icteric infants with bilirubin level greater than 17 mg/dl were randomized in two groups, both groups underwent phototherapy and in the case group intravenous fluid supplementation was added. There were no significant differences in the mean gestational age, birth weight, hemoglobin, and also in total serum bilirubin level at admission in the two groups.
Results: There were no significant differences in the mean rate of of serum bilirubin level decline during first 24 and 48 hours of hospitalization and also the time of bilirubin decreasing to less than 15 mg/dl and the length of hospitalization in two groups.
Conclution: Our study showed intravenous fluid supplementation could be limited to special cases of neonatal icter such as moderate to severe dehydration.
Mirsalehian.a, Nakhjavani.f, Peymani.a, Jabalameli.f, Mirafshar.s M, Hamidian.m,
Volume 65, Issue 1 (5 2008)
Abstract
Background: The incidence of ESBL producing species have been steadily increased in
recent years, resulting in limitation of infection control issues and therapeutic
options.The purpose of this study was to evaluate prevalence of Enterobacteriaceae and
also assess epidemiology ESBL producing strains isolated from patients admitted in
ICUs.
Methods: A total of one hundred fifty isolates were collected from urine, sputum, blood,
wound and other clinical samples from patient admitted in ICU and then were identified
by biochemical tests .All of the samples were screened by DAD method according to The
NCCLS Guideline. The species that met NCCLS screening criteria was further tested for
Clavulanic Acid effect by confirmatory method.
Results: A total of one hundred fifty isolates,133(89.3%) were found to be resistant at
least on of the indicators cephalosporin tested according to NCCLS Guideline.
121(80.6%) of the isolates were resistant to all the indicators tested .89(59.3) isolateds
were confirmed as ESBL producers. The number of isolates ESBL producing was as
follow: Klebsiella pneumoniae 33 (76.74%), E.coli 20 (60.60%), Enterobacter cloacae 8
(47.05%), Citrobacter diversus 6 (54.54%), Enterobacter aerogenes 7 (53.84%),
Citrobacter freundii 4 (40%), Klebsiella oxytoca 6 (62.5%), Proteus mirabilis 4 (50%),
Serratia marcescens 2 (40%), Proteus Volgaris 0%.All of the isolates sensitive to
imipenem.
Conclusion: The present study shows high prevalence of ESBL producing
Enterobacteriaceae from patients admitted in ICU .The increased rate of these species in
most cases due to the administration of inadequate and irrational antimicrobial therapy
.To overcome this problem, it needs to develop new antimicrobial agents, limiting the
Unnecessary Use of antimicrobial and increasing compliance with infection control
issues.
Peyman Dabirmoghadam , Mohsen Sharifi , Seyed Mohsen Banihashem , Zahra Mokhtari ,
Volume 67, Issue 10 (1-2010)
Abstract
Background: Laryngotracheal stenosis is one of the most challenging problems for otolaryngologists. Several methods were developed to treat this problem. However, in many cases, this symptom could be recurred and the patients would suffer from operations for treatment. In this survey, the effect of topical mitomycin-C after laser therapy and dilatation for preventing laryngotracheal stenosis is considered. Methods: Twenty three cases suffered from laryngotracheal stenosis were studied in a clinical trial between years 2006-2007 in Amir-alam educational Hospital in Tehran, Iran. The patients were divided into two groups. In 12 patients (case group), we used topical mitomycin-C (1mg/ml for 4 min) after dilatation and laser therapy, and in 11 of them (control group), this solution was not used. All patients were controlled by endoscopy one and three months later, and then followed up. The results of this study were compared statistically. Results: In the control group after treatment (dilatation and laser), the average changed- vertical and horizontal lengths of stenosis were 0.47±0.77mm and 0.50±0.60mm respectively. However in the control group these changed averages were 2.28±1.15mm and 2.23±1.03mm, respectively after treatment (p<0.0001). The average changed cross section between the two groups were different significantly (p<0.0001), too. Conclusions: In the laryngotracheal stenosis, the use of topical mitomycin-C could reduce the recurrence of the stenosis after dilatation and after the laser procedures. In addition, the need for repeated therapy will be reduced.
Soltan Dallal Mm, Shirazi L, Yazdi Mh, Mahdavi M, Mokarrari S, Rahimi Forushani A, Ghasemi B, Peymaneh Abedi Mohtasab T,
Volume 70, Issue 11 (3 2013)
Abstract
Background: Several reports indicate that the probiotics can increase body resistance against malignant tumors. The aim of this study is to evaluate the effect of Lactobaci-llus reuteri Persian type culture collection (PTCC) 1655 in preventing tumor growth, improving weight and survival rate in mice with breast cancer.
Methods: Twenty mice, the BALB/c at six weeks age, weighing approximately 17 gram were divided into two groups. Oral administration of 500 micro liters of Lactobacillus reuteri suspension performed for the first group 14 days before tumor transplantation. The second group (control) received the same volume of phosphate buffer saline (PBS). Then the mice had tumor transplantation surgery. Lactobacillus reuteri was prescribed in the first group in seven-day period and three-day interruption pattern. At the same time the second group (control) received PBS. This process was continued until 45 day. The tumor growth, histology and body weight were evaluated in both group and the mortality of mice was recorded.
Results: In the mice transplanted tumors that had received probiotics, tumor growth decreased in comparison with control group. In this group the body weight increased (P>0/05). In addition, the survival of these mice had significantly increased compared to control group (P=0.002). The evaluation of tumor tissue also showed increased immune system function in mice receiving the probiotic (P>0/05).
Conclusion: Lactobacillus reuteri can improve immune system function and have an important role to help treatment of cancer.
Reza Pourrashidi, Shervin Sharifkashani , Hashem Sharifian, Habib Mazaher , Peyman Salamati , Batool Ghorbani Yekta ,
Volume 71, Issue 4 (July 2013)
Abstract
Background: Detection of retained foreign bodies remains a significant problem in the emergency department. Foreign bodies can go undetected causing infectious complications ultrasonography is too inaccessible and expensive. The purpose of this study is comparison of ultrasonography with radiography for the detection of cervical esophageal foreign bodies
Methods: This cross-sectional study evaluated 58 patients referred with suspected upper esophageal foreign body in the Emergency Department, Amir Alam. Patients were evaluated with ultrasonography and x-ray. After surgical exploration, different type of foreign bodies were recorded. The SPSS statistical software was used for analysis. For applicable efficacy outcome measures, a Spearman correlation was used. Differences were significant when P<0.05. All values were expressed as the frequency and present.
Results: Fifty eight patients were studied. 25 patients (43.4%) were male and 31 patients (56.9%) were female, in 28 (48.2%) patients foreign bodies were detected in radiography. 30 patients (51.8%) were not recorded in techniqe. It was found in patients 22 (78.6%) organic body, and six cases (21.4%) non-organic body. radiographic outcomes in patients with foreign bodies were positive in 26 patients (92.9%) and in two patients (7.1%) were negative. Ultrasound results were positive in 27 patients (96.4%) and in one patient (3.6%) were negative. Association of ultrasound and radiography results were significant in patients with foreign body (Spearman correlation=0.896, P=0.001 Kappa=0.890).
Conclusion: These reports suggest that result of ultrasound with radiography for the detection foreign bodies in cervical esophagus have good agreement. The use of ultrasonography in the emergency department to detect and eventually remove foreign bodies by emergency physicians is an important issue because there is not always an ultrasound technologist or radiologist available.
Mehdi Amini , Mehrdad Roghani , Peymaneh Shirinbayan , Mohammad Taghi Joghataei , Ali Farhoudian , Mohsen Roshanpajouh , Morteza Koruji ,
Volume 71, Issue 5 (August 2013)
Abstract
Background: Infertility is one of the most serious social problems. Illicit drug use can be an important cause of male factor infertility. Kerack which its use is rising up in Iran refers to a high purity street-level heroin (heroin Kerack). Heroin Kerack used in Iran is an opioid and has harmful effects on body organs. The aim of this study is to investigate the effects of Kerack used in Iran on fertility adult mice.
Methods: In this study, 25 male mice were divided into five groups (control, sham and three experimental). Experimental groups of Kerack-dependent mice (received ascend-ing dose of Kerack for seven days) were divided into three categories, experimental I, II and III. Experimental I was given Kerack at a dose of 5 mg/kg, experimental II 35 mg/kg and experimental III 70 mg/kg, intraperitoneally twice a day for a period of 35 days. The sham group received normal saline and lemon juice (2.6 µl/ml) whilst the control group just received water and food. Mice were then scarified and sperm removed from cauda epididymis were analyzed for sperm count, motility, morphology (normal/abnormal) and viability. Testes were also removed, weighed and processed for light microscopic studies.
Results: The results showed that fertility were significantly decreased in addicted mice compared with control groups (P≤0.05). Epididymal sperm parameters and thickness of seminiferous epithelium were significantly decreased in experimental groups (dose-dependent) compared with sham and control groups (P≤0.05). Gonadosomatic index was significantly reduced with high dose Kerack injected (70 mg/kg) in comparison with control testes (P≤0.05).
Conclusion: This study has shown the deleterious effects of Kerack used in addicted Iranian people on fertility for the first time. This effect is especially on epididymal sperm parameters in adult mice.
Peymaneh Alizadeh Taheri, Fariba Bahmani , Mamak Shariat ,
Volume 71, Issue 5 (August 2013)
Abstract
Background: One of the most common infections in neonatal period is ophthalmia neo-natorum. In this study, the bacterial agents, drug resistance and susceptibility of bacteri-al agents were studied.
Methods: In this study a total of 72 newborns with ophthalmia neonatorum admitted in Bahrami Hospital in Tehran during the years 2008-2011 were continuously enrolled in a case series, descriptive study. Demographic data, including age, sex, cause of admis-sion and culture of discharge from the eyes and its antibiogram, as well as experimental treatments and treatment outcomes were collected.
Results: Forty four infants (61.1%) were males and 28 (38.9%) were females and the mean age on admission was 11.6±7.7 days. In 51 patients (70.8%) the onset of ophthal-mia neonatorum was prior to admission. More than 56% of cases with ophthalmia neonatorum were associated with sepsis. On the other hand, positive blood culture was detected in 15.3% of cases. Among 72 neonates with ophthalmia neonatorum, 26 (36.1%) had a positive culture of the eye discharge. The most common causes of bacterial agents were Staphylococcus aureus (46.1%) (12 of 26 cases). Other causes included streptococcus species (23%), Pseudomonas (15.3%), E-coli (11.5%) and Haemophilus influenza (3.8%). The most frequent causes of drug resistance were Ampicillin, Penici-llin, Cefixime, and Ceftazidime (100% resistance). The most sensiti-ve antibiotics were vancomycin and imipenem (100% sensitivity). Based on the conventional treatment, clinical response to local gentamicin was approximately 60%. Sulfacetamide was associated with no clinical response in 40% of cases.
Conclusion: The antibiogram and clinical response to empiric treatment showed that resistance to ampicillin and some third generation of cephalosporine was 100%. Aminoglycosides’ sensitivity was more than 50% locally and systemically. Our recommendation is performing eye discharge culture before antibiotic treatment. More studies with numerous cases should be done for better definition of bacterial resistance.
Ali Reza Jafari, Ali Akbar Shafiee , Ali Mirzajani , Peyman Jamali ,
Volume 72, Issue 1 (April 2014)
Abstract
Background: The application of CAM visual stimulation returns to the date of more than fifty years ago. However, the reports of previous studies in this field vary from no effect to significant effects of this method in amblyopia treatment. The purpose of this study was to determine the effect of CAM visual stimulation along with conventional occlusion therapy in anisometropic amblyopic children.
Methods: Forty amblyopic children aged 4 to 6 years old with no previous treatment were enrolled in this randomized clinical trial study. The subjects were randomly as-signed in two different groups. The group 1 included conventional occlusion therapy and group 2 includes occlusion therapy with complementary CAM visual stimulation. In terms of visual acuity and stereopsis improvement and reduction of amblyopia sever-ity, two groups were compared using the repeated measure ANOVA and LSD Post Hoc tests.
Results: In group 1 including conventional occlusion therapy, visual acuity improved from 0.444±0.077 logMAR to 0.138±0.023 logMAR, i.e., improvement of 0.306 log-MAR (P< 0.001) whereas in group 2 including complementary CAM usage, visual acu-ity improved from 0.398±0.075 logMAR to 0.047±0.022 logMAR, i.e., improvement of 0.351 logMAR (P< 0.001). Regarding Stereopsis, the improvements were 157 (from 258±34 to 101±13 seconds of arc, P< 0.001) and 171 (from 237±33 to 66±12 seconds of arc, P< 0.001) for groups 1 and 2 respectively. All subjects of group 2 gained the normal vision at the end of the treatment period, whereas only 47% of subjects of group 1 could achieve this level of vision in that time. Improvement of visual acuity in group 2 was significantly better than group 1 (P< 0.05).
Conclusion: Using of CAM visual stimulation along with conventional occlusion will further improve visual acuity and stereopsis in amblyopic children. These findings recommended the CAM visual stimulation as an accompanying and complementary method in amblyopia treatment.
Bahareh Abbasi , Peyman Hafezimoghadam , Naffiseh Ansari Nejad, Maryam Sarvari , Tayeb Ramim,
Volume 73, Issue 8 (November 2015)
Abstract
Background: Tramadol is a synthetic drug which is prescribed in moderate and severe pain. Tramadol overdose can induce severe complications such as consciousness impairment and convulsions. This study was done to determine the convulsions incidence after tramadol use until one week after hospital discharge. Methods: This prospective study was done in tramadol overdose patients without uncontrolled epilepsy and head injury history. All cases admitted in Loghman and Rasol Akram Hospitals, Tehran, Iran from 1, April 2011 to 1, April 2012 were included and observed for at least 12 hours. Time interval between tramadol intake and first seizure were record. Then, patients with second drug-induced seizure were recognized and log time between the first and second seizure was analyzed. The patients were transferred to the intensive care unit (ICU) if clinical worsening status observed. One week after hospital discharge, telephone follow-up was conducted. Results: A total of 150 patients with a history of tramadol induced seizures (141 men, 9 women, age: 23.23±5.94 years) were enrolled in this study. Convulsion was seen in 104 patients (69.3%). In 8 out of 104 patients (7.6%) two or more convulsion was seen. Time interval between tramadol use and the onset of the first and second seizure were 0.93±0.17 and 2.5±0.75 hours, respectively. Tramadol induced seizures are more likely to occur in males and patients with a history of drug abuse. Finally, one hundred forty nine patients (99.3%) were discharged with good condition and the only one patient died from tramadol overdose. Conclusion: The results of the study showed tramadol induced seizure most frequently occurred within the first 4 hours of tramadol intake. The chance of experiencing a second seizure exists in the susceptible population. Thus, 4 hours after drug intake is the best time for patients to be hospital discharged.
Homeira Rashidi , Hajieh Shahbazian , Forogh Nokhostin , Mohammad Bahadoram , Seyed Peyman Payami ,
Volume 73, Issue 8 (November 2015)
Abstract
Background: Metabolic syndromes are known as a set of risk factors for the development of cardio-vascular disease and diabetes in the individual. The association between concentration of uric acid and metabolic syndrome in adolescents has yet to be established thoroughly. The aim of this study was to investigate the relationship between uric acid and metabolic syndrome in a sample of adolescents. Methods: This cross-sectional study was conducted from September 23, 2009 to September 22, 2010 in Jundishapur University of Medical Sciences, Ahvaz, Iran. In this study, 240 individuals aged 10-19 years were randomly selected among participants of the Ahvaz MetS study (120 subjects normal and 120 subjects MetS). The serum levels of UA were measured by a colorimetric method. In the normal group, anyone with abdominal obesity, high systolic or diastolic blood pressure, High-density lipoprotein (HDL)&le40 mg/dl, TG&le110 mg/dl, fasting blood sugar (FBS)&le100 mg/dl or diabetes was excluded from the study. History of Anticonvulsive drugs or steroids use was the criteria for exclusion for both groups. Results: Of the 240 subjects aged a mean of 14.95±2.64 years, mean of uric acid in metabolic syndrome group was 4.8±1.4 mg/dl and in the control group was 4.18±1.01 mg/d (P=0.001). Participants were divided into three groups based on uric acid levels: &le4.9 mg/dl, 4.9-5.7 mg/dl and >5.7 mg/dl. The risk of metabolic syndrome was significantly higher in third group of uric acid than the second and first group (odds ratio [OR], 3.7 95% confidence interval [CI], 1.70 - 8.04) and (OR, 5.9 95% CI, 2.42-14.35, P<0.001). In addition, uric acid level was inversely associated with hyperglycemia. The ORs of hypertriglyceridemia for the second and third group of uric acid were 4.36 (95% CI, 2.01- 9.47) 5.75 (95% CI, 2.43-13.61) respectively, compared with lowest group of UA. Conclusion: The results showed that hyperuricemia was significantly linked with increased risk for hypertriglyceridemia, low high-density lipoprotein cholesterol level, high blood pressure and waist circumference. Among Ahvaz adolescents, serum concentrations of uric acid strongly associated with the prevalence of metabolic syndrome and several of its components.
Abbas Kazemi Ashtiani , Peyman Khoshnood , Mohammad Javad Fatemi , Seyed Jaber Mousavi , Seyed Aboozar Hoseini ,
Volume 74, Issue 10 (January 2017)
Abstract
Background: The use of random flaps is one of the most common methods of reconstructive surgery because they are easy to use and quick to do. However, the absence of axial vessels especially in the distal areas can cause ischemia and loss of total or part of the flap. Different methods and systemic and topical medications have been recommended to prevent ischemia in random flaps. The aim of this study was to evaluate the effect of stem cells derived from umbilical cord blood in random flap survival in rats.
Methods: This experimental study was conducted in Animal Laboratory of Hazrat Fatemeh Hospital in 2012. In this study twenty Sprague-Dawley male rats weighing approximately 300 to 350 g were selected and divided randomly into two groups. In both groups after anesthesia, a flap was created in the posterior part of each rat with a size of 2 x 6 cm. In the intervention group we injected stem cells derived from umbilical cord blood into the flap, and after eight days the effects on the survival of flaps were examined by digital photography and then pathological examination was performed.
Results: The mean of viable flap in the stem cell group was 6.57 cm2 and in control group 4.71 cm2. The minimum and maximum flap survival in the intervention group were 4.71 and 8.75, and the minimum and maximum flap survived in control group were 1.86 and 7.77. This difference was significant and showed that the viable parts of flap were more in the intervention group (P=0.49). In pathologic examinations epidermal and muscle necrosis of the skin were reported in 3 cases in the intervention group and 5 cases in control group.
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Conclusion: This study showed that cord blood stem cells can be effective somehow in reducing ischemia and increasing random flap survival. However, similar studies are recommended in order to compare the results of this drug and placebo or other proven effective drugs.
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Mohsen Shoja, Mohadese Soleimani, Maryam Ameriyan , Niloufar Asbaghipour , Peyman Hejazi Hejazi ,
Volume 77, Issue 2 (May 2019)
Abstract
Background: Today, with the increasing use of ionizing radiation like X-rays in diagnosis and treatment of diseases, the risk of fetal exposure in pregnant women also increases. Therefore, protecting pregnant women from ionizing radiation is essential and is considered as the standard criterion for Medical Radiation Center. So the aim of this study was to investigate the observance of protective principles and 10-day rule in imaging of susceptible women.
Methods: This cross-sectional study was carried out at the Radiography Centers of Semnan University of Medical Sciences, Iran, from July 2017 to September 2017. First, patients who were under radiography, were asked about the knowledge of the radiographers about the 10-day rule and radiation protection. Then a questionnaire with 12 questions was given to the radiographers in radiology and CT scan center. Finally, the existence of protection guidelines for pregnant women was determined by asking manager and checking at the moment.
Results: The patient's question about pregnancy failed about 19%, which did not have a significant relationship with patients' singleness (P=0.0004). Also the mean scores for the knowledge of radiographers about radiation protection were 14.21±0.96, which did not have a significant relationship with their work record and place of employment and their educational level (P=0.09). On the other hand, in half of the radiography centers, the written radiation protection guidelines were not available.
Conclusion: Principles of radiation protection and 10-day rule for radiography of women who were prone to pregnancy were desirable but due to importance of radiation protection, the rules should be more carefully implemented.
Hamidreza Mehryar, Omid Garkaz, Peyman Atabaki, Shadi Gharibi, Nasser Khalili, Sahar Paryab,
Volume 79, Issue 2 (May 2021)
Abstract
Background: Chest pain is the most common reason for patients to be referred to the emergency department of hospitals. This study was performed to compare the GRACE and TIMI scores in predicting important cardiovascular events in patients.
Methods: This descriptive-analytical study was performed on 862 cardiac patients who were referred to the emergency department of Taleghani Hospital in Urmia in the period of April 1, 2016 to the end of September 2016 by census method. A checklist containing demographic information, medical history and risk factors was used to collect data. After scoring patients, we examined and followed up both groups over the next 30 days and recorded any cardiovascular events such as sudden death, AMI or immediate revascularization. The data were tested using SPSS16 and descriptive statistics tests. T-test and ROC curve were analyzed.
Results: The results showed that in general, out of 862 patients who were studied (50.3%), 433 were female and (49.7%) 429 were male. Most of the patients were under 65 years old 627 (72.7%) and the age range was (17-91). The highest initial diagnosis of nonSTEMI patients was UA with 811 (94.9%) cases. On the other hand, the highest risk factors of patients were HTN 449(52%), CAD 314 (36.425) and DM 22 (25.55). The highest blood pressure was between (100-120) with 328 cases and serum creatinine between (0.6 to 1.3) with 770 cases. MACE after 30 days in GRACE system 17 people (32.69%) were in high risk group and in TIMI 3 people (37.5%) were in high risk group. In MACE evaluation, the specificity of GRACE system (cutoff point=30) was 89.27 vs. 52.24, the specificity of TIMI system (cutoff point=7.3) and the sensitivity of GRACE 93 (cutoff point=10) versus TIMI 85.71 (cutoff point=8.3) is.
Conclusion: The results showed that GRACE was more sensitive and characteristic than TIMI. |
Mahnaz Mahmoudi Sohi , Asadollah Asadi , Peyman Brouki Milan , Esmaeil Sharifi, Arash Abdolmaleki,
Volume 79, Issue 4 (July 2021)
Abstract
Background: Wound healing is a complicated process involving the proliferation of the epithelial cells, deposition of granulation tissue as well as recruitment of inflammatory cells. It also is a hot topic of research for trauma, orthopedics and general surgery studies. There are many forms of cells involved in this process. This study aimed to design a tissue-engineered wound dressing consisting of chitosan fibers containing silver ion bioactive nanoparticles for wound healing.
Methods: The present study is an experimental study that was conducted in the research laboratory of the Department of Biology of Mohaghegh Ardabili University from April to November 2019. All experiments of this study have been performed under the ethical guideline of Helsinki and in accordance with the Ethics Committee of the Mohaghegh Ardabili University of Ardabil (Iran). The wound dressing of nanofibers was prepared by the sol-gel method. Cytotoxicity was assessed by MTT assay. Then the antimicrobial properties of nanofibers were determined by the disk diffusion method. SEM and AFM images were obtained from nanofibers. Finally, nanofibers were analyzed by the FTRI method.
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Results: Results of the prepared tissue-engineered wound dressing consisting of chitosan fibers containing silver ion-doped bioactive nanoparticles showed that cytotoxicity was at an appropriate level. The nanofibers prepared with 2% silver nanoparticles produced a 10 mm inhibition zone against Staphylococcus aureus and a 9 mm inhibition zone against Escherichia coli. Therefore, the best percentage of scaffolds in the present study was 2%. Also, results of the SEM micrographs and AFM image analysis of the scaffolds showed that the nanofibers had good roughness and a proper structure for cell seeding and attachments. Besides that, FTIR analysis also showed that the prepared nanofibers had standard bonds.
Conclusion: Chitosan-Silver nanoparticles scaffold have antimicrobial activity on Gram-negative and positive bacteria. The results of the toxicity test also showed that it did not have much toxicity on the cultured cells. Therefore, it can be considered for therapeutic applications, such as wound dressing.
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Hamidreza Shetabi, Khosrow Naghibi , Alireza Peyman, Shima Taghizadeh,
Volume 79, Issue 6 (September 2021)
Abstract
Background: The risk of anesthesia increases with age, so it is necessary to choose a safe and effective method. In this study, we compared the effectiveness of intranasal fentanyl with intravenous fentanyl in patients undergoing cataract surgery.
Methods: This study was a triple-blind prospective randomized clinical trial (The patient, physician, and data analyzer were unaware of the patient grouping). The study was performed from April 2017 to March 2019 in Feyz Hospital, Isfahan, Iran. 90 patients over 18 years of age who were candidates for cataract surgery were included in the study and were divided in two groups receiving intravenous fentanyl (IVF) or intranasal fentanyl (INF). The dose of fentanyl in both groups was 1.5 μg/kg with a maximum of 100 μg. In the IVF group, 1 ml of normal saline was dripped into each nasal passage 10 minutes before surgery and intravenously fentanyl was injected 2 minutes before surgery. In the INF group, 1 ml of fentanyl was administered into each nostril 10 minutes before surgery and 2 ml of saline was administered intravenously two minutes before surgery.
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Results: In this study, there was no significant difference between the two groups in terms of mean heart rate (P=0.762), mean arterial blood oxygen saturation (P=0.262), mean systolic blood pressure (P=0.264), mean arterial blood pressure (0.462), satisfaction rate Patient (P=0.231), duration of surgery (P=0.612) and pain intensity (P=0.87). But in the intravenous fentanyl group (IVF), the level of sedation (P=0.002) and the level of surgeon satisfaction (P<0.001) were higher than intranasal fentanyl group (INF). There was no significant difference between the two groups in terms of side effects (P=0.171) and surgery time (P=0.612). The mean VAS was not significantly different between the two groups.
Conclusion: The study showed that intranasal administration of fentanyl compared with intravenous administration of fentanyl provided similar sedation and cardiovascular response. Intranasal administration of fentanyl is a non-invasive, safe and effective method, that is easy to use and can be a viable alternative to intravenous administration.
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Nasim Vahidfar, Mahdieh Parvizi, Marzyehsadat Peyman, Hana Safar, Saeed Farzenehfar , Mehrshad Abbasi,
Volume 80, Issue 2 (May 2022)
Abstract
Background: Labeled leucocytes could be used for localization of infection foci after surgeries or in inflammatory diseases including inflammatory bowel diseases. Extraction of leucocytes needs 10% Hetastarch which is not available in Iran. We provide a method employing multiple centrifuges to extract and label leucocytes with Tc-HMPAO.
Methods: The study was conducted from April to June 2018 in the Nuclear Medicine Unit of Valiasr Hospital. Leucocytes were extracted from a 60 ml blood sample anticoagulated with Acid-citrate-dextrose through four-step centrifugation as below: 1-whole blood was centrifuged at 1k cycle per minute (CPM) for eight minutes to precipitate red blood cells (RBC). Supernatant including RBC free plasma, WBC, and platelet was extracted for the next step. 2-WBC was precipitated at 1.8k CPM for five minutes and platelet-rich plasma (PRP) as supernatant. 3- PRP was centrifuged at 3k for five minutes and cell-free plasma (CFP) was extracted as supernatant, and 4- precipitate WBS at step two was washed with saline and centrifuged at 0.5k CPM to achieve washed WBC. Then the leucocytes were labeled with 40 mCi Tc-HMPAO through 15 minute incubation at 37-38 degrees centigrade. The extra free pertechnetate was eliminated using two additional centrifugation steps as follows: 1-0.5k CPM for five minutes to dispense free pertechnetate, and 2-0.5 for five minutes to achieve high radiochemical purity labeled WBC. Finally, the labeled WBC was re-suspended in CFP and reinjected to the patient. Imaging at 2-4 hours was done. The pathology and imaging of labeled WBC distribution are reported
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Results: No RBC was detected in microscopy. The majority of the leucocytes were lymphocytes with rare accompanying platelets. The radiolabeling efficiency of the procedure was higher than 40%. The viability test indicated more than 80% of viable cells. The radiochemical purity of the final product was more than 95%. Two to four hours after injection, low background images were acquired. The liver and spleen were target organs with low-grade urinary, thyroid, and GI activity.
Conclusion: Employing multi-stage centrifugation, Tc-HMPAO labeled leucocyte scan could be efficiently performed.
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Rasoul Samimi, Amir Peymani, Samaneh Rouhi , Shadman Nemati, Sanaz Ahmadi, Afra Hossein Panahi , Somayeh Ahmadi Gorji ,
Volume 80, Issue 3 (June 2022)
Abstract
Background: Helicobacter pylori infection and respiratory tract infection at the same time cause pathogenicity increase and death. The aim of this study was to evaluate the co-occurrence of upper respiratory tract disorders and gastrointestinal infections of H. pylori.
Methods: The present study was conducted as a systematic review and meta-analysis, from August 2019 to Agusut 2020, at Qazvin University of Medical Sciences. Articles in the international databases (April 2001-December 2018) on the coexistence of upper respiratory tract disorders with H. pylori gastrointestinal infections were examined. The random effect model with a 95% confidence level was used to analyze the data.
Results: The highest prevalence of respiratory disorders co-occurrence associated with adenoid tissue (33%), nasal polyps (100%), chronic rhinosinusitis (71%) and gastrointestinal infections of H. pylori was reported in 2006 in Turkey, 2011 in Poland and 2015 in Egypt. Concurrent prevalence of the disease, according to the type of upper respiratory tract disorders in all studies, the estimated effect size according to the random model was 53% in chronic rhinosinusitis, 63% in nasal polyps, 62% in adenoid tissue and 60% in total, which was significant (P=0/000). The prevalence of co-occurrence of upper respiratory tract disorders with gastrointestinal infections of H. pylori in patients was estimated to be 61% at the age of more than 27 years and 60% at the age of fewer than 27 years. Pooled estimation of the concurrent prevalence of infection (in total) was estimated to be 60% and was significant among the studies (P=0/000).
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Conclusion: The concurrent prevalence of upper respiratory tract disorders with gastrointestinal infections of H. pylori was observed to be almost equal and significant in elderly and young patients. Due to the fact that the simultaneous occurrence of two types of infections and diseases in people is very dangerous, screening of patients with each of these infections is necessary to identify the other infection and prescribe appropriate drugs.
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Hamidreza Shetabi , Khosro Naghibi, Alireza Peyman, Hamed Norouzi,
Volume 80, Issue 8 (November 2022)
Abstract
Background: To improve the quality of sedation in procedures, different medications are used alone or in combination with each other, but so far, no administration method that is agreed upon by anesthesiologists has been presented. This study aimed to investigate the effectiveness and safety of intranasal ketamine in comparison with intravenous ketamine in cataract surgery.
Methods: This clinical trial was performed from December 2016 to March 2017 in Feyz Hospital, Isfahan. Ninety patients over the age of 18 who were candidates for cataracts surgery were randomly assigned to receive 1 mg/kg ketamine through the nasal route (INk) or intravenously (IVK). Ten minutes before the surgery, ketamine was administered in the INK group and intranasal saline in the IVK group. Two minutes before the start of surgery, normal saline was administered in the INK group and ketamine was administered intravenously in the IVK group. Patients received intravenous midazolam 0.04 mg/kg during prep and drape. The quality of sedation and analgesia, vital signs, patient and doctor satisfaction, and side effects were recorded during the study period. Data were analyzed using of SPSS software, version 23 (IBM SPSS, Armonk, NY, USA).
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Results: In this study, 90 people were included in the study, 53 of whom (58.9%) were men. The mean age of the patients was 61.5±10.6. Two groups had a significant difference in terms of gender (P=0.696), age (P=0.960), weight (P=0.212), height (P=0.632), underlying disease (P=0.094), and type of disease (P=0.090). Two groups were not significantly different in terms of mean heart rate (P=0.77), mean arterial blood pressure (P=0.13), mean blood oxygen saturation (P=0.58), patient satisfaction (P=0.470) and surgeon satisfaction (P=0.115), pain intensity (P=0.506), level of sedation level (P=0.477) and side effects (P=0.221).
Conclusion: Intranasal administration of ketamine provides similar sedation and cardiovascular response compared to intravenous administration of ketamine. Administering ketamine intranasally is a non-invasive, safe and effective method with easy application and can be a suitable alternative to intravenous administration.
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